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Policy, diagnostic imaging

European Directive on radiation exposure will ban MRI scans

27 September 2007

A European Directive aimed at minimising exposure to
radiation will prevent the use of MRI scanners, according to Professor Dag
Rune Olsen of the the Norwegian Radiation Hospital, Oslo.

Implementation
of the Physical Agents (Electromagnetic Fields) Directive 2004/40/EC in all
member states could effectively halt the use of magnetic resonance imaging
(MRI), an important tool in cancer diagnosis, treatment, and research,
Professor Olsen told a press conference at the European Cancer Conference
(ECCO 14) this week. The Directive is due to be implemented across Europe by
April 2008.

The Directive was drafted by DG Employment, with the aim of
minimising workers’ exposure to electromagnetic fields (EMF). Currently
eight million MRI patient examinations per year are carried out in Europe,
said Professor Dag Rune Olsen, who works in experimental radiation therapy
at the Norwegian Radiation Hospital, Oslo, Norway, and is chairman of the
physics committee of the European Society for Therapeutic Radiology and
Oncology (ESTRO). “But these are likely to have to stop, since the Directive
sets limits to occupational radiation exposure which will mean that anyone
working or moving near MRI equipment will breach them, thus making it
possible for them to sue their employers. Even those maintaining or
servicing the equipment may be affected,” he said.

A British study into
operator exposure to electromagnetic fields from MRI, published by the Heath
and Safety Executive in June 2007, found that anyone standing within about
one metre of an MRI scanner in use would breach the exposure limits laid
down in the directive. The Commission has accepted this, and said that it
will consider the HSE report together with the study it has commissioned
itself, and which is due for publication in October 2007, when deciding
whether and how to propose amendments to the directive or to extend the
implementation period.

“But they may already be too late,” said Professor
Olsen. “Slovakia has already implemented the directive, on the grounds that
it was based on the assumption that the limits which it sets would have no
effect. This would appear to mean that it is now illegal to carry out MRI
scanning in the country.”

The directive in its present form poses
particular problems to those healthcare staff who care for patients such as
children, the elderly, or those who have been anaesthetised, who need help
and comfort during scans. It will also stop the use of MRI for
interventional and surgical procedures, and will curtail cutting-edge
research.

A recent Eurobarometer (Europe-wide opinion poll) showed that
most EU citizens felt that they were inadequately protected by authorities
against the potential health risk posed by electromagnetic fields. More than
two-thirds of people interviewed said that they were not satisfied with the
information they received on EMF, and one-third said that they had not been
informed at all.

However, in the medical field, the use of MRI may lead to
more exposure to radiation rather than less, said Professor Olsen. “MRI has
to a certain extent contributed to a limit in the increase in the use of
ionising radiation in medical imaging, for example, in CT scans. This is
important with respect to radiation-related cancer mortality risks and is,
as such, in line with requirements laid down in EURATOM Directive 97/43
regarding optimisation and justification of medical exposure to ionising
radiation,” he said. “If the public were informed of this I am sure that
they would be as keen as I am to see that MRI is allowed to continue. The
added value that MRI represents to medical diagnostics has been tremendous.

“Policy-making should be based on sound science, and to my knowledge there
is no scientific evidence of long-term adverse health effects of exposure to
static or fluctuating magnetic fields that are commonly found during MR
scanning. Hasty decisions without scientific support will in this case have
a severe impact on medical diagnostics and must thus be avoided. I hope that
the Commission will allow a delay in implementation to enable it to examine
this issue again and that the Directive could be amended to allow an EU-wide
derogation for MRI,” he concluded.